Study of Combined Coronary CT Angiography and CT Perfusion for Detailed Assessment and Management of Coronary Artery Disease

What this Trial Is About

Researchers are investigating the use of combined coronary computed tomography angiography CTA and CT myocardial perfusion CTP imaging to improve the diagnosis and management of coronary artery disease CAD. This study addresses the limitations of CTA alone in assessing the functional significance of coronary lesions, especially in cases with borderline stenosis, severe calcification, or coronary microvascular dysfunction. It aims to evaluate the long-term prognostic value of integrating anatomical and functional imaging findings alongside AI-driven analysis to enhance personalized risk assessment and treatment decisions. The study observes patients undergoing either conservative management with medical therapy and lifestyle interventions or invasive coronary angiography ICA potentially combined with procedures like percutaneous coronary intervention PCI, intravascular ultrasound IVUS, optical coherence tomography OCT, or fractional flow reserve FFR. Imaging assessments include detailed plaque characterization and perfusion analysis using AI tools to quantify relevant markers. The research team will monitor clinical decisions influenced by imaging results, such as the need for revascularization or additional testing, and stratify patients into subgroups for further analysis. Participants will be followed over a five-year period to track major adverse cardiovascular events MACE and assess the predictive power of combined imaging biomarkers. Diagnostic accuracy of combined CTACTP will be compared with invasive reference standards within 30 days. Other evaluations include changes in myocardial perfusion related to symptom relief and the impact of severe calcification on diagnostic performance. The study involves comprehensive data collection on clinical outcomes, imaging metrics, and therapy adjustments to refine non-invasive approaches for CAD management.

Combined Coronary CT Angiography and CT Perfusion in Coronary Artery Disease (CoroFusion)